﻿<div class="modal-header">
  <h3>{{headerText}}</h3>
</div>
<div class="modal-body">
    <div>
        <div>
            <form name="form">
                <label for="firstName">First Name</label>
                <input type="text" id="firstName" name="firstName" ng-model="selectedUser.firstName" required/>
                <label for="lastName">Last Name</label>
                <input type="text" id="lastName" name="lastName" ng-model="selectedUser.lastName" />
                <label for="gender">Gender</label>
                <input type="radio" id="male" name="gender" ng-checked="!modalOptions.selectedUser.gender" /><span class="gender-text">Male</span>
                <input type="radio" id="female" name="gender" ng-checked="modalOptions.selectedUser.gender" /><span class="gender-text">Female</span><br />
                <br />
                <label for="mobile">Mobile</label>
                <input type="tel" id="mobile" name="mobile" ng-model="modalOptions.selectedUser.mobile" />
                <label for="email">Email</label>
                <input type="email" id="email" name="email" ng-model="modalOptions.selectedUser.email" />
                <label for="country">Country</label>
                <select id="country" name="country" ng-model="modalOptions.selectedUser.country" ng-options="c.id as c.name for c in countryList"></select>
                <label for="state">State</label>
                <select id="state" name="state" ng-model="modalOptions.selectedUser.state" ng-change="clearCityAndZip();" ng-options="s.id as s.name for s in countryList[0].states"></select>
                <label for="city">City</label>
                <select id="city" name="city" ng-model="modalOptions.selectedUser.city" ng-options="c.id as c.name for c in selectedState.cities">
                    <option value="" selected="selected">Select City</option>
                </select>
                <label for="zip">Zip</label>
                <input type="text" id="zip" name="zip" ng-model="modalOptions.selectedUser.zip" /><br />
            </form>
        </div>
    </div>
</div>
<div class="modal-footer">
  <button type="button" class="btn" 
          ng-click="close()">{{closeButtonText}}</button>
  <button class="btn btn-primary" 
          ng-click="ok();">{{actionButtonText}}</button>
</div>
